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Invisible illness increases risk of suicidal ideation: Role of social workers in preventing suicide

Dolphin

Senior Member
Messages
17,567
[This is a sympathetic article. It is just three pages long. Unfortunately it is not open access]

Source: Health & Social Work

Date: June 14, 2017

URL: https://academic.oup.com/hsw/article-abstract/doi/10.1093/hsw/hlx029/3867907/Invisible-Illness-Increases-Risk-of-Suicidal

Invisible illness increases risk of suicidal ideation: The role of social workers in preventing suicide

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Cathy L. Pederson(1), Kathleen Gorman-Ezell(2), Greta Hochstetler-Mayer(3,*)

1 Department of Biology, Wittenberg University, Springfield, OH.

2 Department of Social Work, Ohio Dominican University, Columbus.

3 Mental Heath and Recovery Board of Cark, Green, and Madison Countries, Springfield, OH

* Corresponding author



Abstract

Many chronic, invisible illnesses that involve chronic pain - fibromyalgia, complex regional pain syndrome, postural orthostatic tachycardia syndrome, and myalgic encephalomyelitis - can greatly affect both physical and mental health.

Although these illnesses are not fatal, they severely affect function and quality of life (Pederson & Brook, 2017).

It is interesting to note that these disorders disproportionately affect women (Alonso & Hernan, 2008; Branco et al., 2009; Carew et al., 2009), who are often thought to exaggerate symptoms and may not be taken seriously by the medical community.

One study showed that nearly 50 percent of women with postural orthostatic tachycardia syndrome fell into the high-risk group for suicide (Pederson & Brook, 2017).

Clearly, we need to care more for these chronically ill women to decrease suicide risk.

Keywords: Topic: social work, feeling suicidal, suicide precautions
 

Dolphin

Senior Member
Messages
17,567
Mental illness and substance use disorders do not account for all thoughts of suicide in the chronically ill population. It is worth noting that chronically ill people who admitted suicidal ideation scored lower on indicators of previous psychiatric illness and alcohol or drug abuse than the general population (Stenager et al., 2014). The sense of isolation, hopelessness, loss of financial stability, and loss of relationships increase the likelihood of suicidal ideation (Liu & Miller, 2014). Furthermore, perceived burdensomeness is a known predictor of suicidal ideation in the chronically ill (Kanzler et al., 2012; Van Orden, Lynam, Hollar, & Joiner, 2006; Wilson, Kowal,Henderson,McWilliams, & Peloquin, 2013), as are illness duration and insomnia (Tang & Crane, 2006). Many who have invisible illness experience life weariness, that is, they are tired of living but don’t necessarily want to die (Newton- John, 2014).
 

Dolphin

Senior Member
Messages
17,567
People with invisible illness often feel ignored or abandoned by the health care system. Many health care practitioners simply are not educated about compassionate treatment of people with these debilitating illnesses. As a result, many practitioners blame the patient for poor outcomes. Imagine how such repeated negative experiences might erode hope for recovery and could lead to suicidal thinking. Taking the time to learn about a client’s illness can greatly increase empathy, provide authentic understanding, and help in guiding the person to proper medical care (Pederson & Mayer, 2016).
 

Dolphin

Senior Member
Messages
17,567
Social workers can also address the fallout for families living with chronic illness by teaching them to speak openly and honestly about how illness, pain, isolation, and other factors affect their relationships. Social workers help families to understand that symptoms can appear quickly and unpredictably, and that it is counterproductive to punish their loved one for increased symptomology. They encourage family members to stay in contact through text messaging, calling, or home visits to promote social connection and sense of belonging ( Joiner, 2005). Isolation and hopelessness breed suicidal ideation when coupled with chronic pain.
 

Dolphin

Senior Member
Messages
17,567
Warning signs:
Teach families that talking about wanting to die, feeling hopeless, or experiencing unbearable pain could indicate an imminent attempt at suicide. Giving away prized possessions, saying good-bye, and making comments like “Nobody will miss me” or “You’ll be better off without me” must be taken seriously. Families and friends need contact information and resources available should they become concerned about suicidal ideation.
 

Dolphin

Senior Member
Messages
17,567
Advocacy at the macro level may focus on ensuring that individuals are provided the necessary resources to manage their chronic invisible illnesses. This may include accommodations through Section 504 of the Americans with Disabilities Act; funding and coverage for comprehensive treatments (both physical and emotional); or adequate access to health insurance, social security, and disability insurance. Social workers can empower the chronically ill individual as well as his or her family and friends to serve as advocates within the health care system and the larger public to ensure that greater understanding and supports are developed for those with invisible illness. By decreasing the stigma and isolation associated with chronic invisible illnesses, social workers have the ability to empower and enhance the lives of many who are suffering in silence and isolation.
 
Messages
94
I try to do everything possible for my daughter to make her life easier. I never thought that might make things harder for her.
Edit: I very much doubt that you are. Asking yourself that question is a pretty good indicator that you're doing so so many of the right things. But if you do want suggestions, these were my thoughts from my own experience.

Is it possible to help her do something for you? I know that making other people happy helps me.
Doesn't have to be big. Anything she can do to make you smile would be favourite.

[My husband helps me make his favourite dinner. Or sits me near the kitchen and gets me to read the instructions for his favourite cookies that he puts together. ... or keeps my tiny spade sharp, collects me gravel, and lets me dig a useful path, one square at a time over months.
(Edit: my elderly father moved in with us so I could look after him. Ironic now. But I still bake him his daily bread in stages over 48hrs and tend to cuts and bruises, which helps him and makes me feel useful. He used to see something I had stopped doing and finish it but, if I were just doing it in stages, that made me feel, just a bit, useless. Or he'd help out in the garden and make different choices from my plan. Too much brain fog to tell him that too. Now he asks if I'd like him to light the fire now or if he can carry the buckets of mulch along the path so I can finish putting it where I want it etc, and he waits a day before finishing off the laundry or the dishes so, if I'm doing it to feel useful, I can finish it in my own time - I usually do.)
It all depends on what's doable. Stroking your forehead at the end of a long day?]
 
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alex3619

Senior Member
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13,810
Location
Logan, Queensland, Australia
Is it possible to help her do something for you? I know that making other people happy helps me.
Being able to do the tiniest thing to help is good. Its one of the reasons I advocate.

However the very severe end of the spectrum cannot engage like this. They need even more support from those around them, but in a very subtle way as they cannot handle too much stimulus. Its very hard to do I imagine.
 
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3,263
Thanks for the link, @CFS_for_19_years

Its a very compassionate and thoughtful piece. These were interesting observations:
paper said:
Many who have invisible illness experience life weariness, that is, they are tired of living but don’t necessarily want to die
paper said:
Sadly, a chronic invisible illness can put even the strongest relationships in jeopardy. ..Missed holidays, birthdays, and other social events leave loved ones feeling betrayed and wondering if the person could make a better effort to be present. Some become confrontational, and others turn passive aggressive. Because emotional and physical pain is invisible, it is easy to forget the internal battles waged every day by those with chronic illness.... Social workers understand the impact of the larger social system on an individual. As such, it is critical to provide intervention and support for the family and friends of individuals with invisible illnesses. Caregivers ... need to be empowered and supported so they guard their own health and can continue to meet the needs of their loved ones.

Social workers help families to understand that symptoms can appear quickly and unpredictably, and that it is counterproductive to punish their loved one for increased symptomology. They encourage family members to stay in contact through text messaging, calling, or home visits to promote social connection and sense of belonging
paper said:
Advocacy at the macro level may focus on ensuring that individuals are provided the necessary resources to manage their chronic invisible illnesses. This may include accommodations through Section 504 of the Americans with Disabilities Act; funding and coverage for comprehensive treatments (both physical and emotional); or adequate access to health insurance, social security, and disability insurance.
paper said:
By decreasing the stigma and isolation associated with chronic invisible illnesses, social workers have the ability to empower and enhance the lives of many who are suffering in silence and isolation.

As often, I'm uncomfortable with the way these sorts of pieces focus so heavily on avoiding the disaster that is suicide, when really, the bigger problem is that life for many severely ill people is hard to endure.
 

user9876

Senior Member
Messages
4,556
Thanks for the link, @CFS_for_19_years

Its a very compassionate and thoughtful piece. These were interesting observations:





As often, I'm uncomfortable with the way these sorts of pieces focus so heavily on avoiding the disaster that is suicide, when really, the bigger problem is that life for many severely ill people is hard to endure.

The bits of the paper you quote is about the social worker educating the family. In my experience its the family who need to educate social workers who have very little understanding of what it means to live with chronic illness.
 

Invisible Woman

Senior Member
Messages
1,267
I try to do everything possible for my daughter to make her life easier. I never thought that might make things harder for her.

I don't know how old you daughter is but I'm sure your love & support are much appreciated.

It's been a long time since I was a kid but I imagine that the feeling of being a burden & all that entails might be stronger as one reaches adulthood. A younger child or teen might experience resentment at a loss of independence & needing help more & this might at times be experienced or expressed as a resentment against the carer.

The only way to know for sure is to talk to your daughter & allow her to discuss how she feels about being ill (I daresay you do that anyway).

Maybe, in return, you could let her know a little of how you feel - being very careful. Just so she can ask you & discuss it with you. Then rather than thinking the worst she can talk to you.

Of course all this depends on how severely she's affected.

Well or ill, I'm sure she knows you love her very much & would move mountains for her. That's the most important thing of all.
 
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94
Thank you @Woolie, @Invisible Woman, @alex3619 and @Sean. That's much more what I wish to say.
@Sad Dad i jumped in with whatever I could think of because I didn't want to leave you alone with that thought. You are very evidently doing so much to help her, you are here. I wish that is what I said.
One thing you are also doing for her, which is essential, is recognising what she is going through, that it is a real condition, that she is doing the best she can, that everything about this thing is hard. And you are there for her. So many don't. Don't worry about making it worse, she needs that rest. the fact that you read this article and asked yourself that question, assures me you're doing a great job.
 
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Messages
52
Thanks for the link, @@CFS_for_19_years. It reminded me that CFS sufferers experience a wide variety of interpersonal and professional relationships, and it's impossible to make predictions about where they will get the most support.

As often, I'm uncomfortable with the way these sorts of pieces focus so heavily on avoiding the disaster that is suicide, when really, the bigger problem is that life for many severely ill people is hard to endure.
I hope everyone has been able to find someone they can candidly talk with about what they are going through, and everyone should at least try to have those conversations with the people they are close to.

For what it's worth, I assure you that the people who love you feel your pain. I know from experience what it's like to wake up in the morning wondering if last night was her last night.

Sad Dad is an ambiguous moniker. I'm really just sad for my daughter and what she's going through and that I can't do more for her. That being said, I appreciate everyone's support.
 
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